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Name
*
First Name
Last Name
Additional Donor Name
First Name
Last Name
Email
*
Sign me up for Vermont Works for Women's e-newlsetter
Address
*
Address Line 1
Address Line 2
City
State/Province
ZIP/Postal Code
Country
Donation Amount
*
$
Donation Schedule
One Time
Monthly
Quarterly
Annually
Send my acknowledgement letter:
*
via e-mail
via snail mail
Gift Recognition
Please recognize my gift as from:
e.g. 'Jane Doe' or 'Jane and John Doe' or 'The Doe Family' or 'Company Name'
Is this a tribute gift?
If yes, you'll be able to specify the honoree in the next step.
No
Yes, an honorary gift
Yes, a memorial gift
Please provide the name and contact information of the honoree
Provide a mailing address or an email address if it's ok for us to let them know about your gift.
Name of the deceased
Please provide contact information for a friend or relative
Any other instructions?
Add 3% to my total amount to help cover the payment processing fees